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Organization
THE MANOR
Active
Organization
THE MANOR
Active
Other names
Leslie M. Bennett, MD
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRED PRASSER (PRESIDENT/CEO)
(517) 849-2151
Entity
Organization
Contact information
Practice address
115 EAST ST, JONESVILLE, MI 49250-1007
(517) 849-2151
(517) 849-2880
Mailing address
115 EAST ST, P.O. BOX 98, JONESVILLE, MI 49250-1007
(517) 849-2151
(517) 849-2880
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
4301075087
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4210900
—
MI
Enumeration date
11/02/2006
Last updated
08/22/2020
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